Corticosteroids for preventing relapse following acute exacerbations of asthma

A short course of corticosteroids following assessment for an acute exacerbation of asthma reduces the number of relapses and decreases beta-agonist use without an apparent increase in side effects.

A Cochrane review included 6 studies with a total of 374 subjects. One study used intramuscular corticosteroids, five studies used oral corticosteroids. Significantly fewer patients in the corticosteroid group relapsed to receive additional care in the first week (relative risk [RR] 0.38; 95% confidence interval [CI] 0.2 to 0.74). This favourable effect was maintained over the first 21 days (RR 0.47; 95% CI 0.25 to 0.89) and there were fewer subsequent hospitalizations (RR 0.35; 95% CI 0.13 to 0.95). Patients receiving corticosteroids had less need for beta2-agonists (mean difference [MD] –3.3 activations/day; 95% CI –5.6 to –1.0). Changes in pulmonary function tests during the first 7–10 days, while rarely reported, showed no differences between the treatment groups. NNT for relapse to additional care after an exacerbation of asthma was 10.

Ədəbiyyat

1. Rowe BH, Spooner CH, Ducharme FM, Bretzlaff JA, Bota GW. Corticosteroids for preventing relapse following acute exacerbations of asthma. Cochrane Database Syst Rev 2007;(3):CD000195.